Difference between revisions of "Xu2019"
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#<span style="font-size:medium;"><span style="font-family:">No blinding means there is a possibility of bias in this study through participation in the HBO arm.</span></span> | #<span style="font-size:medium;"><span style="font-family:">No blinding means there is a possibility of bias in this study through participation in the HBO arm.</span></span> | ||
#<span style="font-size:medium;"><span style="font-family:">Donezepil is a cholinesterase inhibitor used to treat Alzheimer’s Disease (not vascular dementia).</span></span> | #<span style="font-size:medium;"><span style="font-family:">Donezepil is a cholinesterase inhibitor used to treat Alzheimer’s Disease (not vascular dementia).</span></span> | ||
| − | #<span style="font-size:medium;"><span style="font-family:"> | + | #<span style="font-size:medium;"><span style="font-family:">Outcomes are very short-term (2 days after treatment completion).</span></span> |
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<span style="font-size:medium;">'''<span style="font-family:">Appraised by:</span>'''<span style="font-family:">Hannah Rubinstein h.rubinstein@student.unsw.edu.au; Monday, 29 November 2021</span></span> | <span style="font-size:medium;">'''<span style="font-family:">Appraised by:</span>'''<span style="font-family:">Hannah Rubinstein h.rubinstein@student.unsw.edu.au; Monday, 29 November 2021</span></span> | ||
| − | + | <span style="font-size:medium;">'''Kill or Update By: '''November 2025</span> | |
<p style="text-align: center;"> </p> <p style="text-align: center;">[[File:Sumhorsa.gif|center|Sumhorsa.gif]]</p> <p style="text-align: center;"><span style="font-size:xx-large;">[[Neuro_-_miscellaneous|BACK]]</span></p> | <p style="text-align: center;"> </p> <p style="text-align: center;">[[File:Sumhorsa.gif|center|Sumhorsa.gif]]</p> <p style="text-align: center;"><span style="font-size:xx-large;">[[Neuro_-_miscellaneous|BACK]]</span></p> | ||
Latest revision as of 00:55, 21 December 2021
The addition of hyperbaric oxygen to treatment with donepezil did not importantly improve cognitive outcomes in patients with vascular dementia.
Clinical bottom line:
- Hyperbaric resulted in improved Mini Mental State Examination (MMSE) scores
- Hyperbaric also resulted in increased serum humanin levels which may have a correlation with cognitive function
Citation/s:1. Xu Y, Wang Q, Qu Z, Yang J, Zhang X, Zhao Y. Protective effect of hyperbaric oxygen therapy on cognitive function in patients with vascular dementia. Cell Transplantation 2019; 28(8):1071-1075.
Lead author’s name and fax:Y. Zhao : zhao_yuwu2005@126.com
Three-part Clinical Question:In patients with vascular dementia, does treatment with hyperbaric oxygen and donepezil in comparison to donepezil alone result in an improvement in cognitive function?
Search Terms:Vascular dementia; cognitive function; humanin
The Study:Non-blinded non-concealed randomised controlled trial with intention-to-treat.
The Study Patients:Patients who met DSM-5 diagnostic criteria for vascular dementia. Patients with other forms of dementia, mental illness, brain trauma and severe systemic diseases were excluded.
Control group(N = 79; 79 analysed): Donepezil hydrochloride 5mg daily.
Experimental group(N = 79; 79 analysed): Donepezil hydrochloride 5mg daily and HBO 100% O2 at 2.0 ATA for 60 minutes 5 days per week for 12 weeks for a total of 60 sessions.
The Evidence:
Measure |
Control group |
HBOT group |
Difference |
95% CI | ||
Mean value |
SD |
Mean value |
SD | |||
|
MMSE |
20.1 |
2.8 |
21.7 |
2.4 |
1.6 |
-0.4 to 3.7 |
|
Humanin |
143.1 |
8.6 |
146.5 |
9.4 |
3.4 |
-22.1 to 28.9 |
Comments:
- The authors’ treated MMSE scores as continuous and normally distributed – this is probably not appropriate. Their analysis suggests the difference between means is statistically significant (P<0.001), but we cannot confirm that on our analysis. Neither can we confirm the significant humanin analysis. The reason for the discrepancy is unclear.
- The authors identified a correlation between MMSE scores and humanin levels after adjusting for confounding factors. Humanin has no definitive clinical application currently.
- No blinding means there is a possibility of bias in this study through participation in the HBO arm.
- Donezepil is a cholinesterase inhibitor used to treat Alzheimer’s Disease (not vascular dementia).
- Outcomes are very short-term (2 days after treatment completion).
Appraised by:Hannah Rubinstein h.rubinstein@student.unsw.edu.au; Monday, 29 November 2021
Kill or Update By: November 2025
